Growing up, I probably wasn’t what you’d call an outdoorsy kid. When I was 8 and newly diagnosed with type 1 diabetes (T1D), my favorite activity was curling up with a good library book. The extent of my exposure to the outdoors was the occasional family walk in a local nature preserve.
Still, I think a big part of my resistance to all things outdoors stemmed from my less than stellar diabetes control. With diabetes, it seemed dangerous to leave the confines of a town or city with emergency medical services — and even more so when your control was poor, like mine.
Like many of my T1D peers, I struggled with diabetes burnout (“diaburnout”) all through my teenage years. I was so tired of having to think about my levels 24 hours per day. And more than anything, I was tired of feeling ashamed when my parents asked me how my blood sugars were doing.
So, one day I just stopped.
Predictably, my blood sugar levels and A1C (a measurement of my average blood glucose levels) creeped up. At the time, I assumed the lethargy I couldn’t remember not feeling was just part of being a teenager. Luckily, in college I began seeing an endocrinologist who started me on a continuous glucose monitor (CGM).
CGMs are made up of a glucose sensor that you wear on the surface of your skin, which sends blood sugar readings to an external device (in my case, an app on my phone) regularly throughout the day.
Once I started witnessing my blood sugar trends in real time, I finally felt empowered to take my health back.
The CGM also brought some unexpected benefits. For one, it allowed me to see how my levels changed during different activities — which is when I started to discover the power of being outdoors. Not only did I feel better when I was being active, but my blood sugars were better.
Outdoors, this chronically ill body of mine could prove to the world that nothing would stop us.
In nature, there was no judgement of how I cared for myself, just my own opinions on whether I could finish my hike or push myself to go a little faster.
Out there, I was an adventurer first and a diabetic second.
No matter who you are, which chronic condition you might be living with, or what your ability or experience has been, I believe that time spent outdoors — discovering somewhere or something new — can be life changing. And if you do it safely, I think these moments of self-discovery are for everyone.
But I know it can be hard to start if you’re new to this world. It can feel overwhelming to jump into unfamiliar territory, where the rules and habits that keep you alive in your day-to-day life may not apply.
So, in that spirit, here are a few tips I wish I had known when I was first discovering my outdoorsy self:
Do your research
Planning in advance can allow you to adjust your insulin routine based on how your body responds to different types of exercise. When I’m preparing for a hike, my first step is checking resources like AllTrails.com, so I know how strenuous the hike will be.
My blood sugar tends to drop like it’s hot when I do strenuous cardio but actually rise with more anaerobic muscular exercise.
My takeaway? If I’m trekking uphill at a steep incline, I’ll cut my basal, or background insulin. If the hike is short but full of rock scrambles or something else that requires me to use my upper body strength, I might just leave my basal rates alone.
Trial and error is key
Be prepared for some trial and error if adjusting your basal. I figured out what works best for me by testing with small adjustments first. Take it from me, there are few feelings more miserable than having to hike uphill while fighting off a high blood sugar headache.
Bring water — lots of it
Trust me on this one: if you think the thirst of high blood sugar is awful at ground level, adding elevation and then removing access to water will not help.
No matter what kind of adventure you’re into, staying hydrated is always a good idea.
Start off strong with a meal that will make you feel good
Don’t start your day with a sugary, high-carb meal.
On days when I eat, say, a doughnut before I start a hike, I tend to shoot up and hover around that level before all the insulin hits and I crash. My best days are when I start my day with a breakfast higher in fat and protein.
In a nutshell, it’s best to avoid taking big doses of insulin before hiking, so starting with a meal like this makes a huge difference.
Keep an eye on the thermometer
Watch out for extreme temperatures, and check the weather forecast before you leave. If you’re driving out to Zion in the middle of the summer, maybe don’t leave your insulin out in the car while you hike. And if your insulin starts looking cloudy, toss it. (Be sure to pack more insulin than you need for just this reason.)
Have a backup — for everything
Once, when I was on a canoeing trip on the Shenandoah River, we hit a current and our canoe sank. I’d thought to put my cell phone into a dry bag, but not my insulin pump, the OmniPod PDM. Cue the panic.
Luckily, I had brought a full set of insulin pens, pen needles, and a manual glucose meter and strips. Crisis averted! (And if you’re on a pump, consider asking your doctor to prescribe you a vial or two of long-lasting insulin and syringes so you can have those as backup just in case your pump completely dies.)
Finally, don’t let cost be a barrier
There are 63 amazing national parks in the United States — and you can visit all of them with the National Park Service’s Access Pass, a free, lifetime pass for people with disabilities.
Not everyone with T1D chooses to self-identify as living with a disability, and that’s OK. At the end of the day, it’s a personal choice.
But even without the pass, there are still hundreds of state parks, wilderness areas, national forests, and more that have more affordable (or even free) entrance fees.
I really do believe that diabetes shouldn’t hold you back from anything, whether that’s scuba diving the Great Barrier Reef, backpacking through Europe, summiting the world’s highest mountain peak, or anything in between.
And that feeling of accomplishment you get at the end of a journey that physically challenges you and pushes you to your limit? It’s worth it every time.
Alex Day is a passionate national parks lover, and spends her days managing marketing and communications for the primary philanthropic partner to the three national parks in her adopted state, Washington. She believes that national parks and time spent in the great outdoors bring value for everyone, no matter their ability — a belief that’s close to her heart because she has lived with type 1 diabetes for almost 2 decades. Next up on her bucket list is summiting peaks in each of the three parks, starting with Mount Rainier. You can follow her adventures, alongside her rescue pup, Finn, on Instagram.
